PHYSICIAN FOCUS: Blood pressure: don't ignore it

According to the U.S. Centers for Disease Control and Prevention, 1 out of every 3 Americans or more than 70 million people has high blood pressure.

Dr. Mario E. Motta/DAILY NEWS CORRESPONDENT

According to the U.S. Centers for Disease Control and Prevention, 1 out of every 3 Americans or more than 70 million people has high blood pressure. And it hits males and females about equally: among adults 20 or older, 31 percent of women and 29 percent of men have high blood pressure or are taking medication for the condition. In Massachusetts, CDC estimates about 1 in 5 residents are affected.

The alarming fact is that many people don't know they have high blood pressure. Of those who do, an estimated 70 percent don't keep it under control. Those are dangerous situations: If ignored or left untreated, high blood pressure can lead to serious, even life-threatening problems. Here's some basic information about this important vital sign.

What is blood pressure?

Blood pressure is the force of blood pushing against the walls of blood vessels as blood moves through your body. It's measured with two numbers: The top number (systolic) measures the blood when the heart beats; the bottom (diastolic), when your heart is at rest. Normal blood pressure is considered 120/80 or below.

What is considered high blood pressure?

Blood pressure varies throughout the day, but high blood pressure, also called hypertension, is a measurement of 140 systolic and/or 90 diastolic (or greater) that remains for an extended period. Under these conditions, your blood is moving with such force that over time it could damage your arteries or vessels.

What is "prehypertension"?

Adults are considered to have "prehypertension" when either systolic blood pressure measures 120-139 or diastolic pressure measures 80-89. CDC estimates that 28 percent of adults have prehypertension. Physicians recommend that this condition be addressed as well.

Who is most at risk?

Several groups: those with a family history of the condition; African Americans, who have a higher incidence (40 percent) than other ethnic groups; and people who are over 35 years of age, overweight and physically inactive. Also at risk are people who consume too much salt and alcohol; people with diabetes, gout or kidney disease; pregnant women; and women who take birth control pills.

What causes high blood pressure?

In 90 percent of cases, the cause is unknown. Abnormal conditions of the kidney or aorta, the main blood vessel leading from the heart, or a narrowing of arteries, which hinders blood flow through the body, may influence the other 10 percent.

What are the dangers of high blood pressure?

High blood pressure is a major risk factor for heart disease and stroke, the No. 1 and No. 3 causes of death in the U.S. It can also lead to kidney failure and peripheral artery disease.

What are the symptoms of high blood pressure?

There aren't any. That's why it's important not to ignore it or consider it a minor problem.

How do you control or lower high blood pressure?

Hypertension can't be cured but can be controlled. The best steps are changes in diet and lifestyle. Lose weight if you're too heavy; eat a diet low in fat, cholesterol and salt; drink alcohol in moderation; make exercise a regular part of your life; and don't smoke. Your physician may also prescribe medication, according to your individual situation.

Can children get high blood pressure?

Yes. Because of differences in body size, however, the standard for high blood pressure in children is different from adults. The American Heart Association recommends that children 3 and up have yearly measurements.

Is low blood pressure dangerous?

Generally no, but low blood pressure can be dangerous if it drops suddenly or is accompanied by symptoms like dizziness or fainting. Extremely low pressure may signal heart, endocrine or neurological conditions and could affect vital organs. If you have prolonged low blood pressure, measured at 90/60 or lower, and experience symptoms, see your physician.

Where can I find more information?

Two good Web sites that provide useful information are those of the American Heart Association at americanheart.org and the Centers for Disease Control at cdc.gov.

Mario E. Motta, M.D., a cardiologist with North Shore Cardiovascular Associates in Salem, is president-elect of the Massachusetts Medical Society. Physician Focus is provided as a public service by the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org.

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